STATE OF NEW YORK
COUNTY OF ___________________________
CITY COURT of the CITY OF ______________
_______________________________________
THE PEOPLE OF THE STATE OF NEW YORK

NOTICE OF APPEAL
vs
Docket No. ________

Defendant
_______________________________________

PLEASE TAKE NOTICE THAT THE ABOVE NAMED ____________________________
(Defendant/Appellant)HEREBY APPEALS TO THE ___________________________ COUNTY COURT FROM
(name of County)THE CONVICTION ENTERED ON __________________________ AND FROM EVERY
(date)PART THEREOF.